Hepatobiliary-specific contrast agents are one of several classes of contrast agents available for magnetic resonance (MR) imaging of the liver. These agents are taken up by functioning hepatocytes and excreted in the bile, and their paramagnetic properties cause shortening of the longitudinal relaxation time (T1) of the liver and biliary tree. The three contrast agents that have been developed are mangafodipir trisodium (Mn-DPDP), gadobenate dimeglumine (Gd-BOPTA), and gadoxetic acid (Gd-EOB-DTPA). These three MR contrast agents vary in mode of administration and dose, mechanism of cellular uptake, degree of excretion through the biliary pathway, and imaging characteristics. In the liver, hepatobiliary-specific agents can be used to improve lesion detection, to characterize lesions as hepatocellular or nonhepatocellular, and to specifically characterize some hepatocellular lesions, notably focal nodular hyperplasia. Biliary excretion of these agents can be used to evaluate the anatomic structure and function of the biliary tree. In the future, hepatobiliary-specific contrast agents may have wider applications, such as grading of cirrhosis and quantification of liver function.

https://pubs.rsna.org/doi/pdf/10.1148/rg.296095515

Hepatobiliary-specific MR Contrast Agents: Role in Imaging the Liver and Biliary Tree

A hypothetical anatomic model formulated by integrating the observed variations and their anatomic pathways may help diagnostic and/or interventional radiologists understand the underlying developmental basis of the diverse variations observed in clinical practice.

Celiac Axis and Common Hepatic Artery Variations in 5002 Patients: Systematic Analysis with Spiral CT and DSA

Pure laparoscopic right hepatectomy in a living donor.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29293

Recommendations on the use of magnetic resonance imaging in PSC-A position statement from the International PSC Study Group

Real-time Simultaneous Near-Infrared Fluorescence Imaging of Bile Duct and Arterial Anatomy

Accurate preoperative assessment of the hepatic vascular and biliary anatomy is essential to ensure safe and successful hepatic surgery. Such surgical procedures range from the more complex, like tumor resection and partial hepatectomy for living donor liver transplantation, to others performed more routinely, like laparoscopic cholecystectomy. Modern noninvasive diagnostic imaging techniques, such as multidetector computed tomography (CT) and magnetic resonance (MR) imaging performed with liver-specific contrast agents with biliary excretion, have replaced conventional angiography and endoscopic cholangiography for evaluation of the hepatic vascular and biliary anatomy. These techniques help determine the best hepatectomy plane and help identify patients in whom additional surgical steps will be required. Preoperative knowledge of hepatic vascular and biliary anatomic variants is mandatory for surgical planning and to help reduce postoperative complications. Multidetector CT and MR imaging, with the added value of image postprocessing, allow accurate identification of areas at risk for venous congestion or devascularization. This information may influence surgical planning with regard to the extent of hepatic resection or the need for vascular reconstruction.

/pdf/vascular-and-biliary-variants-in-the-liver-implications-for-55rhn5hrm6.pdf

Vascular and biliary variants in the liver: implications for liver surgery.

A Prospective Randomized Controlled Trial of NOTES versus Laparoscopic Distal Pancreatectomy: Preliminary Results

The advent of multidetector computed tomography (MDCT) scanners has provided an impetus for various changes in applications of computed tomography (CT) principles and their implementation in the design of CT protocols. The advanced MDCT scanners can produce isotropic voxel resolution, which can improve detection of subtle lesions in the organ. It thus remains the major imaging modality for detection of hepatic pathologies [1, 2, 3, 4].

Anandkumar H. Singh

Papers

Vascular and biliary variants in the liver: implications for liver surgery.

A Prospective Randomized Controlled Trial of NOTES versus Laparoscopic Distal Pancreatectomy: Preliminary Results

Dual-Phase Liver MDCT